How to cope with being in a teen psychiatric ward

In a recent article published by U.S. News, more than four million children and teens have a mental illness. Sadly, a study by University of California, San Francisco revealed that hospitalizations for teen mental health treatment increased for teens by 24% between 2007 and 2010. The results of the study indicated that one out of 10 hospitalizations for teens and children are due to a psychological illness, such as depression, bipolar disorder, or psychosis.

Typically, when teens and children are hospitalized for teen mental health treatment concerns, their lives or the lives of others are in danger as a direct result of the psychological illness. In California, a police officer or a qualified mental health professional will deem a teen to be a danger to self (suicidal) or others (homicidal). A child or teen may likely be psychologically unstable and medical attention is needed to provide stabilization.

Hospitalization is a form of psychiatric treatment and is the most intense and the highest level of treatment there is for children, adults, and adolescents. A psychiatric hospital provides 24-hour care that is designed to meet severe changes in mood and behavior, particularly for adolescents with acute mental illnesses. Often, hospitals provide a locked environment with clinical supervision in order to provide the highest levels of safety.

It’s common for psychiatric hospitals to have two wings, one for females and one for males. Each patient has one roommate and there are several rules to ensure safety. For instance, teens cannot close the door all the way, cannot wear shoelaces, and teens with eating disorders are closely monitored while and after eating times. There are frequently specific times when all patients not under close watch are administered their medication. And in order to promote good behavior, teens are typically on a point system, which allows them more privileges as points increase. However, when a patient has either a behavioral or psychiatric outburst, he or she is separated from the group. If that teen doesn’t calm down, a sedative is provided, and if it’s refused, then a teen is held down and the sedative is injected instead.

A teen’s stay at the hospital, which can last from 24 hours to a month or longer, will likely include psychotropic medication, assessments, individual or group therapy, support groups, and family therapy. Teens who are hospitalized for the long-term may attend school for a few hours a day. Psychiatric treatment, however, is the main focus of a teen’s stay, and typically time spent at a psychiatric hospital is meant to be brief.

Ideally, psychiatrists at the hospital are communicating with an adolescent’s parents, primary care physician, and mental health professionals who have also provided care. It can be very challenging for a teen to be admitted to the hospital and provided a prescription for an anti-depressant, for example, that is different than the one he or she normally uses. When there is lack of communication among treatment professionals, hospitals can sometimes prescribe different medication at a different dosage, which can make the experience for the teen uncomfortable and even upsetting. Fortunately, cross-communication among community agencies, including hospitals and mental health professionals are getting better for this reason.

Hospitalization for an adolescent is frequently an unpleasant experience. However, it is a place that provides the kind of intense care that is necessary for psychiatric stability. Of course, most parents do not want their children to be a part of the statistics on teen mental health treatment. Parents can avoid trips to hospital by watching for warning signs such as self-harming activities, drop in grades, or social withdrawal.

It’s not an easy experience to have to be hospitalized, whether it’s for a physical or a mental illness. It can be frightening for the person being hospitalized as well as his or her family members.

And there are often symptoms of traumatic stress that come with knowing that you will be staying at a hospital for a few days or a few weeks. Hospitals can trigger feelings such as uncertainty about what might happen, fear of having to go through a painful experience, fear about what others might think of them, fear of dying, and fear of being permanently labeled. These feelings can then bring on symptoms of anxiety and nervousness, including:

  • Being easily upset
  • Feeling anxious or nervous or stressed
  • Feeling confused
  • Feeling numb or empty inside

Typically, when teens and children are hospitalized for mental health concerns, their lives or the lives of others are in danger as a direct result of the psychological illness. In California, a police officer or a qualified mental health professional will deem a teen to be a danger to self (suicidal) or others (homicidal). A child or teen may likely be psychologically unstable and medical attention is needed to provide stabilization.

Hospitalization is a form of psychiatric treatment and is the most intense and the highest level of treatment there is for children, adults, and adolescents. A psychiatric hospital provides 24-hour care that is designed to meet severe changes in mood and behavior, particularly for adolescents with acute mental illnesses. Often, hospitals provide a locked environment with clinical supervision in order to provide the highest levels of safety.

It’s common for psychiatric hospitals to have two wings, one for females and one for males. Each patient has one roommate and there are several rules to ensure safety. For instance, teens cannot close the door all the way, cannot wear shoelaces, and teens with eating disorders are closely monitored while and after eating times. There are frequently specific times when all patients not under close watch are administered their medication. And in order to promote good behavior, teens are typically on a point system, which allows them more privileges as points increase. However, when a patient has either a behavioral or psychiatric outburst, he or she is separated from the group. If that teen doesn’t calm down, a sedative is provided, and if it’s refused, then a teen is held down and the sedative is injected instead.

Just reading this might ignite some tension and fear. However, here are some ways that you, your spouse, and the rest of your family can support your teenager:

Include your teen in medical discussions with the psychiatrist whenever possible. It’s important that your teen ask the questions that he or she needs to. Encourage your teen to participate in the discussion surrounding medication, symptoms, diagnoses, and treatment. This is not only important now, but it will be important in the future if the illness is a long-term experience. Your teen will need to know how to have these conversations with doctors in the future.

Talk about your feelings together. When you and your teen have the opportunity to do so, sit down with one another and talk honestly and openly about your fears, concerns, doubts, and frustrations. When your teen can feel the support of his or her family can make the burden of the experience a little lighter.

Help your teen stay connected with friends. This means that now is a great time that your teen could use the support of old friends. And it’s also a great time to make new friends as well. The more support your teen has, the better he or she might feel.

Find ways of respecting your teen’s privacy. Your teen is going to feel conscious about the way he or she looks. It’s comes with being an adolescent. Reassure your teen while being honest, and give him or her time for self-care.

These are only a few ways to support your adolescent if he or she needs to be hospitalized. Although it’s not an easy experience, you and the rest of your family can provide assistance through love, compassion, and presence.

By Chris Bonine

How to cope with being in a teen psychiatric wardWhen the hospital doors close behind you for the first time, it often feels more like the beginning of a prison stint than the start of a journey to recovery. The immediate deprivation of personal choice and the creature comforts of private life only seem to reinforce this perception. So do the round-the-clock surveillance and the long stretches with little more to do than watch television and speak with your peers.

Despite this, stays on acute psychiatric wards often occur at important crossroads in life — during periods of overwhelming stress or insurmountable grief, for instance. And while the psychiatric ward does a good job in securing the individual from harm to self or others, it can also provide them the time and space to improve other areas of life if they choose to do so.

Here are a few tips to help a patient make the most of a stay on an acute psychiatric ward, so that the “first day of the rest of your life” is a healthier one, as well.

Smoking Cessation

With tobacco use identified as a major, but preventable, contributor to several of the leading causes of death in the U.S., it makes sense that one would want to stop smoking as soon as possible. However, in the thick of a stressful situation, smoking cessation may not be thought of as the urgent priority it is. To the contrary, some might lean on smoking as one of the few stress-relievers available.

The fact that many acute psychiatric wards either do not allow smoking or do not have the facilities to accommodate smoke breaks can sometimes make smoking cessation not only appealing, but necessary. Additionally, the availability of nursing and health care staff make this an ideal opportunity for a patient inclined to stop their use of tobacco to receive education on how to quit. They can also see how they tolerate other smoking cessation interventions (e.g., patches, gum, etc.), and develop other — healthier — habits to replace the urge to smoke.

As part of discharge, staff can help connect you with materials and resources to make the smoke-free life a permanent change.

Blood Sugar and Diabetes

Diabetes affects a significant number of psychiatric patients, potentially due to the metabolic effects of many psychiatric medications. The rate of diabetes is between double and triple that of the general population for those with severe mental illness.

Untreated diabetes can result in loss of vision and decreased sensation in the extremities, among other symptoms that would only serve to complicate existing stressors. However, many diabetics find success in addressing diabetes by better monitoring their blood sugar. Being more mindful of sugar intake and its impact on hemoglobin A1C — one of the leading indicators in tracking risk for diabetes — can help someone slow the onset of the condition or avoid it altogether.

An inpatient stay on a psychiatric ward provides an ideal time for staff to routinely monitor your blood sugar, draw A1C labs and help you see firsthand the connection between your dietary intake, serum glucose and hemoglobin A1C. This can be the first step to a healthier future.

Sleep Hygiene

A psych ward stay is a time to tune out the “noise” of life and focus on nothing but your health, including as your sleep. A good night’s sleep has an immeasurable effect on your mood and mental state.

Unfortunately, the acute psychiatric ward is not known for being conducive to sound sleep. The observation schedules wards maintain to ensure that all patients are safe varies from hourly to constant. This can present a significant disruption to your rest.

However, you can use this time to determine what helps you achieve a solid block of sleep. Do you prefer to sleep with the window open? With music? What sleep aids have been helpful? Does melatonin work or does chamomile tea do the trick?

Sleep is also diligently monitored in psychiatric wards. Your stay is a good opportunity to consider the sleep data staff collect and brainstorm with them about strategies for improving your sleep.

Stress Reduction

Perhaps chief among the benefits of a stay on an acute psychiatric ward is that no one in your immediate surroundings has any major expectations of you, in the sense that they are not “depending” on you. The only focus is on stabilizing your mental health and getting you to a state where you can go back to regular life.

This freedom can allow you to step back, re-evaluate how you have handled stress previously and devise new ways to overcome it upon your return to the outside world. Reflection, as well as the use of insight to identify the connection between stress, coping mechanisms and undesirable outcomes, can be a major benefit of staying on the ward if you decide to use your time there this way.

Please consider these tips as you engage in purposeful recovery and your next comeback!

Chris Bonine is a psychiatric nurse at a federal hospital and has experience in residential treatment, as well as both acute and long-term psychiatric wards.

Although I kept quiet about it, and most people didn’t know, I spent the past two months in an intensive mental health program. While I was there, however, things took a turn for the worst and I ended up needing an inpatient stay at the psych ward. It was unpleasant, but it did help my medications get straightened out, and I felt a lot more stable coming out of it. I felt like I was finally getting back to standing on my own two feet again. However, life has taught me never to get too comfortable — I should have known better.

After my psychiatric hospitalization, I ended up returning to work after a two-month medical leave. I’m a teacher and was extremely excited, as I really missed my students. Of course, as it goes, one of them was sick with a cold the week I came back, which I then became sick with a week later.

Except for me, the cough got so bad I couldn’t breathe. I ended up going to urgent care one night a week after I returned and I was given a cough suppressant and inhaler. If that didn’t help, they told me I should get a chest X-ray because I probably had pneumonia.

Long story short, the medications didn’t help. By Tuesday night, I could barely walk without completely losing my breath. So, I went to my local emergency room to get a chest X-ray. I figured it was just another case of pneumonia, as I’ve gotten pneumonia three times before. I was used to the cough and the shortness of breath. I just wanted them to give me some antibiotics so I could head back into work soon.

Well, the chest X-ray came back negative. So, they thought maybe I had a blood clot and asked if they could run a chest CT. The good news is, I didn’t have a blood clot. However, my lymph nodes were extremely enlarged — even for someone who has an infection, so I was told I might have cancer and to see an oncologist right away.

I remember leaving and laughing because that just wasn’t possible. First of all, I tried too hard to kill myself to wind up with cancer as soon I was stable again. That would be a sick joke. Second of all, I’m only 26. People my age don’t get cancer.

Except, after seeing numerous oncologists, I found out, I do. I have non-Hodgkin’s lymphoma. To say I have a complex relationship with my diagnosis is an understatement.

For context, I spent two years cycling in and out of psych wards. My mental illness is debilitating enough where at one point, my loved ones and treatment team suggested it was time to start thinking about applying for disability. I spent my childhood living through multiple traumatic situations, and I spent the next five years after trying to learn how to cope with it.

I worked hard to graduate college this past January. I worked hard to secure a job as a full-time teacher directly after graduation. I worked hard to get to where I am. So, having a mental health relapse this spring was difficult, because I knew I should be celebrating. I should be having the time of my life and enjoying my “big girl job.” Instead, I was in another round of treatment for my mental health. Then, directly after being stabilized, I find out I have cancer?

It’s all been a punch in the gut. While I embrace my mental illnesses, I can also acknowledge I’ll always feel like I’ve lost years of my life because I was unable to fully engage in what was happening around me. Whether it was due to being in hospitals or just being extremely symptomatic, I spent years being unable to hold down a job, unable to attend university and unable to maintain a friendship, nevermind a relationship.

I was excited to finally be stable and able to do those things again when I got discharged from my latest psychiatric stay. Yet, now it’s like I’m seeing my life flash before my eyes again.

And it’s hard. It’s really hard, in fact. Lately, my biggest feat is getting out of bed in the morning. I’m not going to kill myself, but I am having suicidal thoughts again due to finding out I have cancer. Because I don’t want to deal with it. Having cancer on top of everything else is just… too much. It’s too much for me to handle. Most of the time, I feel like I’m at my breaking point.

Yet, still, as much as I hate it sometimes, a part of rebuilding my life from the ground up meant finding things to live for. It meant getting married, becoming a dog mom and finding my passion in helping those with disabilities. So, as much as I’d love to end my life sometimes, I also have to cope with the fact that even though I do have cancer, I’ve come a long way. And even though it feels like my life will never be the same again, I have the coping skills to keep going, despite the fact sometimes I don’t want to.

But I’ll be honest: It’s still hard. I have more bad days than I do good right now. My brain likes to trick me that it’s my fault I have cancer, and a lot of times it likes to go to dark places, causing panic attacks, crying spells and an overall sense of being too overwhelmed to cope. I’m not very social, and I’m not a fun person to be around right now.

I am trying, though. I like to joke around if I’m not allowed to kill myself, cancer is certainly not allowed to do the job for me. I know it’s a morbid thought, but right now my morbid sense of humor is the only thing keeping me from succumbing to the darkest parts of my mind.

But I’d be lying if I said I’m not waiting for the day where this all gets easier. The day where having cancer is an afterthought and not in the forefront of my mind all the time. And for my sake, I’m hoping that day comes soon. But just in case it doesn’t, I’m learning how to be OK with not being OK. Because I will be OK eventually. Today’s just not that day.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.

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For me, being admitted to hospital was a big turning point in my recovery. It was the ‘kick’ that I needed; it was the moment in which I sat down and faced up to why and what I was feeling.

In late July my crisis team admitted me to an acute mental health ward, where I stayed for little under a week. It was only a short period, and I was discharged to the Home Treatment Team, however, my time in hospital seemed significant and momentous. My time in hospital was difficult, overwhelming and relieving. My time in hospital triggered a huge shift in my ability to cope and move forward. It was life-changing.

For me, being admitted to hospital was a big turning point in my recovery. It was the ‘kick’ that I needed; it was the moment in which I sat down and faced up to why and what I was feeling. On the first night of my hospital admission I stood in the bathroom – the only bit of privacy I had – and cried. I cried so hard that I’m pretty sure I dealt with a lot of stuff right there in that moment – and I told myself, at that point, that certain things (traumas) will no longer impact me the way that they had been, I would not allow them to.

And I’ve been keeping to my word – when things have been overwhelming I’ve thought back to that moment – the moment in which I can quite honestly say was the worst moment of my life (for now – and hopefully forever). I’m not exaggerating either, for me being in hospital was devastating. I felt trapped, scared and 100% broken. I hated myself for ‘letting it get this far’ – for not wanting to continue fighting, and for being at the complete mercy of all the rubbish that has happened in my life. I didn’t want to let past events impact me the way they did – but I couldn’t figure things out – think, or picture my life any different.

I’d been trying desperately to keep everything to myself – why bring others into this mess? This was something I had to figure out and deal with myself. But now it’s not. I think for me agreeing to a hospital admission – although I didn’t have much choice – was still something that I had done. I had agreed to the admission, rather than being under a section, and I was in ‘control.’ (Of course, I wasn’t in complete control, but I could hold onto that thought). As an informal patient I could ‘leave’ whenever I wanted to – though I was told that if I asked to be discharged and they felt I wasn’t ready they could section me – so, instead I sat tight and tried my hardest to make the most of the situation. I decided to work for my recovery – basically, I decided to fight for my life. (Something that I had, in all honesty, not been doing).

Being in hospital was tricky – I felt too anxious to join in with any of the ward activities – though one of the nurses did convince me to participate in a pampering session with another patient – which I actually found to be very soothing. (I’m a big fan of muscle relaxation exercises, and we did this whilst wearing face masks – which was nice). That was the only ward activity that I participated in, and it wasn’t until the day of my discharge that I finally managed to convince myself to go to the kitchen and actually eat breakfast.

For the most part of my inpatient time I was asleep. I slept so much – I’d wake, take my medication, go back to sleep, wake for lunch, go back to sleep, wake for dinner, watch some TV, go back to sleep, wake, freak out in the middle of the night, go back to sleep and repeat. When I was awake I was too anxious or overwhelmed to think, and all I wanted to do was go home. I spent the first two days crying at everything – feeling horribly trapped.

But, the differences in my coping strategies were slowly beginning to change. When I was admitted I told one of my friends the next day, and cried over the phone to her – something that I thought I’d never do. I hardly cry, and I very rarely tell my friends how I’m feeling – so that was a pivotal moment for me – reaching out. My friend came to visit me, and I let my housemates know too. And someone from work was regularly emailing me and keeping me going – which was more helpful than I could ever articulate.

My hardest decision was choosing not to tell my parents. Everything in me wanted to tell them, but I didn’t want to hurt them, I didn’t want to panic them. As soon as I was admitted I knew that things had already changed, suddenly I felt able and willing to fight. But I knew I had to take the time to actually face up to things and figure out how to move forward – and I knew that this was something that I needed to do for myself. The last thing I wanted was for my parents to feel responsible or as though they hadn’t done enough. Because they have done enough, they have done so much for me – if it wasn’t for their support and love I wouldn’t have agreed to my hospital admission. Things would have ended a lot differently. My parents have supported me through everything, and reacted in the best possible way when I did finally tell them after my discharge. They gave me space, they were, and are a constant, supportive team. They are always there for me – they believe in me and respect, accept and support the decisions I make. I couldn’t ask for anything better. It’s my parents that drive my recovery – whether they know this or not.

My experience as an inpatient on a mental health ward was, for me, terrifying. I felt so hopeless – but I quickly learnt and accepted that it was a huge step, and I feel so fortunate to have been given that chance. I’ve heard horror stories concerning mental health admissions – patients having to travel hours away to find a bed, patients not being able to access beds and so forth.

I was incredibly lucky, I was given a bed on a ward just five minutes drive from my house – with lovely staff (and the food was amazing). The stress and emotion of the admission was far too overwhelming and difficult for me to deal with. I’m very independent, and inward facing, in terms of my recovery – I don’t like talking to new psychologists, or doctors, or staff, and group therapy terrifies me – being in an environment where I was able to ‘break down’ was new and strange. Having staff there who were willing to listen and help 24/7 was a lot for me to take in, but it allowed me to make sense of things, and figure out my path. I don’t know how I would cope with another admission, the emotion was so heavy and exhausting – I knew that being on the ward was making me anxious – it was heightening my anxiety, but it was helpful at the same time. I was scared of the staff and patients, I was continuously weary of being judged, even though some of the patients were experiencing very similar things to me, I just wanted to go home, to have the chance to ‘deal’ with things myself. Which is why I knew I had to stay, and allow myself to acknowledge and open up to what I was going through. I had to learn how to deal with things in a healthy way. I was given the chance, and the space to fight for my recovery. I had my own room, a team of wonderful staff – and, most importantly – the desire to move forward and live my life.

When I was discharged my first thoughts were “I never want to go back,” but in reflection – inpatient care was vital to me staying alive. The staff, the other patients, and those who supported me during and after the admission all helped me find reasons to keep fighting. Of course I’m terrified of a relapse – my home treatment team have been amazing, and now I am letting others help and support me – it’s wonderful.

Although it was exhausting and overwhelming inpatient care was definitely the right thing for me. It saved my life.

You’ve seen movies like Girl, Interrupted, One Flew Over the Cuckoo’s Nest, Shutter Island, and 12 Monkey. So, you’ve probably formed some ideas about what psych wards are like. And, these ideas are probably not-so-accurate. After attempting suicide, I landed in the psych ward and learned a few things. Here are 5 things no one tells you about the psych ward.

#1. It’s somewhat “normal” for addicts to have gone to the psych ward

Hollywood has probably done the public a disservice as far as how psych wards are depicted in movies. Don’t get me wrong, these places generally are not somewhere you want to be, although, the people who end up here do generally realize that they need the help. There are seriously ill people in the psych ward as well as people “like us.”

When I was in the mental ward of my town’s hospital, I was *lucky* enough to have a roommate who was like me – a normal type of crazy, not, soil-yourself-and-the-common-area-furniture type of crazy. She was a young lawyer who had checked herself into the psych ward because she thought she was going crazy (turns out, she’s alcoholic). It’s quite common for alcoholics and addicts to have spent time in the psych ward before they get clean and sober. That’s why it’s said: “We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions, and death” – where “institutions” includes psych wards and mental hospitals.

#2. You might be there for more than three days

Regardless of whether you sign yourself in voluntarily or you are ordered to go to the psych ward, most hospitals can hold you for 72 hours for psych-related reasons without your permission. Even if you’re truly OK, the hospital needs to ensure that you aren’t going to leave and immediately have some kind of “episode.”

After three days in a psych ward, you can leave … if the doctors say you can leave. That is, it’s at the doctors’ discretion after evaluating you, whether you can leave.

#3. It’s not long-term

Despite the movie depictions, and also because healthcare and especially mental healthcare has changed so much, psych wards are not the long-term institutions they used to be. The mental hospitals of the cinema are filled with people who are clearly just “eccentric” – being held against their will, either planning their escape or manipulating the system as best they can in order to get “released.” All this is good news because, upon entering, all of your personal belongings are confiscated.

#4. It’s not a detox

As mentioned in #1, we alcoholics and addicts often end up in a psych ward at some point in our active addiction. Sometimes, it is our only recourse for getting some relief and help, especially when it comes to dealing with withdrawal symptoms. Although the psych ward is not the same thing as a detox, oftentimes a hospital’s chemical dependency ward is part of the same program as the mental ward.

#5. You’re diagnosis might change

There are two main things to consider here. One is that navigating the brain – how it works and how it “malfunctions” – is not an exact science.One of the most frustrating things about a serious mental illness is that you (and the doctor) almost can’t know exactly what’s going on. Your brain changes as you age, so it’s possible for your disorders to evolve. Since the doctors can’t be 100% sure what’s wrong, they can’t be sure that the treatment is going to work.

The second thing to keep in mind is this: if you are diagnosed with a mental illness or disorder in the midst of your active addiction or even within 6 months of last drug use, your diagnosis might be wrong.

This is because drugs affect the brain in such a profound way that we can start displaying behaviors and thought patterns that mimic a mental illness. It isn’t until we get clean and sober and stay sober for a period of time that we can be sure whether a diagnosis is accurate. Many times, people in recovery who, at one time were diagnosed with a mood disorder, realize that it simply isn’t the case.

While I was in the psych ward, I was diagnosed with bipolar disorder. And no doubt, I was certainly acting like someone with the disorder. I was obviously depressed and, now, as the cocktail of drugs I had taken with the purpose of overdosing was clearing my system, I was becoming more and more manic; I was displaying racing thoughts and speech and experiencing a racing heartbeat. So, for years, I thought I had bipolar disorder when it was really chronic depression. It wasn’t until I went to treatment and got some clean time under my belt that I realized this.

If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.

Working with delusions is similar to hallucinations, except that more non-verbal techniques are required. You will need to sit in silence longer and with more patience, as delusions do not tend to go away, ever. The person may not verbally express them as often, but they are usually omnipresent.

1. Establish a trusting, interpersonal relationship

  • Do not reason, argue, or challenge the delusion. Attempting to disprove the delusion is not helpful and will create mistrust.
  • Assure the person that they are safe and no harm will come.
    Do not leave the person alone – use openness and honesty at all times.
  • Encourage the person to verbalize feelings of anxiety, fear, and insecurity – offer concern and protection to prevent injury to themselves or others.
  • Convey acceptance of the need for the false belief.
  • Focus on building a trusting relationship with the person, rather than the need to control their symptoms – remain calm.

2. Identify the content and/or type of delusion

  • Empathize with the person and try to understand the purpose behind the delusion.
  • Paraphrase what the person is saying or trying to say to clarify any confusion about the delusion they are describing.
  • Without agreeing or arguing, question the logic or reasoning behind the delusion. For example: “If the CIA are harassing you, who is the contact person?”
  • Do not confirm or feed into the delusion by asking questions about it when the person is not in psychosis. For example: NEVER ask, “How’s the CIA today?” when the person is well.
  • Identify what might be the central topic.
  • Identify the main feeling and/or tone of the delusion.

3. Investigate how the delusion is affecting the person’s life

  • Assess if and how the delusions are interfering with a person’s life. For example, are they are no longer able to function or participate in regular everyday life?
  • Assess if the delusion is affecting a person’s relationship with others.
  • Determine if the person has taken action based on their delusion.

4. Assess the intensity, frequency, and duration of the delusion

  • Keep a log documenting the intensity, frequency, and duration of a person’s delusion.
  • Determine if their delusions tend to occur at a certain time of day or are related to certain activities or actions. This can help you look for ways to avoid situations that may trigger paranoia or delusions.
  • Some delusions are fleeting and brief, while others are more long lasting and endure over a long period of time.

5. Attempt to redirect or distract the person from their delusion

  • Does the person always greet you with the delusion? If so, just quietly listen and then give direction for the task at hand.
  • If it appears that the individual cannot stop talking about the delusion, ask gently if they recalls what you have been doing and that it’s time to resume that activity.
  • If the person is very intent upon telling you the delusion, just quietly listen until there is no need to discuss it any further.
  • Remember that it is helpful to give the person reassurance during the delusion that they, as a person, are okay.

Ways to cope with someone who has delusions

Try to offer empathy and focus on the emotions that the person is experiencing. Arguing facts and details may cause the person to shut down and perceive you as judging them. By offering support with no judgement that doesn’t confirm or deny the delusion, the person may feel consoled and trust that you care for them. Some things to keep in mind as you speak to the person:

1. Pay attention to the emotions of the person

2. Discuss the way you see the delusion

3. Express that you are concerned about the person

4. Offer to pursue therapy together but be strategic

5. Ask the person why they believe as they do and be open-minded

6. Avoid getting frustrated and expressing that to the person

7. Learn about Cognitive Distortions or Thinking Errors

8. Model engagement in reality testing

Information for these strategies are from Tamara Hill’s article on PsychCentral, an independant mental health website with information and content overseen and created by mental health professionals.

Spring can be a tough time in the world of a teenager. Yes, the flowers are blooming, the trees are getting greener and the air is filled with the sweet scent of spring flowers. But many high schoolers are experiencing the stress of finals, sitting for AP exams, taking or re-taking the SAT or ACT, navigating the college application process, and of course, preparing for prom. And if those tasks aren’t already anxiety provoking, let’s not underestimate the power of peer approval. School has become somewhat of a social minefield for teens, and acceptance from their peers is imperative.

And those are just a fraction of the stuff that concern teens this time of year.

Rising academic standards, increased competition for colleges, extracurricular activities, and bourgeoning romantic interests are all aspects of being a teen that can lead to feelings of failure and rejection… which can then open the doorway for anxiety.

Anxiety is a normal and unavoidable part of life, especially when experiencing something new or transitioning to a new stage in life. For teens, anxiety can show up in a number of ways: shortness of breath, picking of skin, feeling overwhelmed, or feelings of sudden panic are just a few. Anxiety can even show up in one’s thinking patterns such as in “what-if” thoughts about being judged or criticized, and persistent worries about the future.

The way you acknowledge and respond to a teen showing signs of anxiety is critical in helping them to foster a sense of competence. What can parents do to help teens manage high anxiety periods? Here are five simple strategies to consider:

1. Spending quality time.

Adolescence is often characterized as a stage of waning parental influence as children begin to slowly distance themselves from the values of their parents. While there is truth to that theory, it does not tell the full story. Years of experience in education and mental health has taught me that while parent-teen relationships are not always peaceful, they can be pivotal. Teenagers need their parents and other loving adults to guide them as they develop and mature. There are studies that even suggest that teenagers need more quality time from parents than toddlers! Open communication and support can buffer some of the turbulence of adolescence. Making yourself available physically and emotionally—even when you feel pushed away—during stressful periods outweighs any previous conflicts. Impromptu conversations during family meals and while driving to the soccer field really matter. Over time, both parents and teens will balance the need for independence and closeness.

2. Encouraging a tech break.

Due to the pervasiveness of technology in our society, teens—and adults—find it difficult to unplug. A student recently shared her experience with a one week “Social Media Detox” challenge posed by her English teacher. While the thought of giving up Instagram and Snapchat was initially terrifying, she observed how immensely freeing it eventually became. Most teens are connected to technology each day and more so for social reasons rather than academic ones. The challenge for parents is that it is nearly impossible to limit access to most forms of technology, and you may not even desire to. However, guidance and supervision is still important, even in the teen years. Focus on moderation rather than prevention. Participating in a self-imposed break can help to reduce the feelings of pressure in an already overwhelmed teen. For those reluctant to detox completely, offer up a compromise of deleting saved bookmarks from their internet browser, or turning off email notifications on their smart phones . . . at least for a weekend.

3. Sharing your experiences.

Adolescence is a time for identity formation. With the increasing pressures of academic achievement and fixations around appearance, it is no wonder that teen anxiety is on the rise. Despite mounting pressures, one comforting fact is that teens respond favorably to, and learn from anyone to whom they feel a personal connection. One parenting tip that I frequently offer is to reflect about a time when you faced a similar challenge as your teen is facing or experienced debilitating anxiety. Aim for a 10-15-minute conversation with your teen while in the car or when taking the dog for a walk. Before doing so, ask yourself the following: What did you wish your parents had done to help you? What would you have wanted to hear? What did they do that you valued and respected? Respond to your teen with empathy and share how you successfully managed the issue. Or, how maybe you weren’t so successful initially. Then allow your teen to explore his or her own thoughts and feelings related to what you’ve shared.

4. Offering perspectives.

Journeying from childhood to adulthood is difficult. In just a few short years, teens go through a significant number of physical and emotional changes. Also, decisions such as where to apply to college or who to ask out for prom may seem exciting to onlookers but may trigger feelings of dread for a teenager. The reality of independence can be terrifying. Teens often feel the pressure to be all things to all people. Remind your teen that who they are is much more important than their SAT score or who they date. Encourage your teen to view their worries about their future as a normal and natural part of growing up. Parents can take concrete steps to help their teen better understand their unique experiences through journaling, reading short stories, and watching films that celebrate the adolescent journey. Yes, some choices about the future need to be made now, but it is okay to not know everything and to continue to explore. Offering perspective and repeatedly reminding your teen that they are fully accepted just for who they are, goes a long way towards enhancing self-esteem and decreasing anxiety.

5. Getting physical.

Teens need both challenge and involvement. The teens that I work with often describe anxiety as “. . . wanting to jump out of my skin.” Anxiety can be both mentally and physically draining. Teens are often short on energy because of too little physical activity. Balancing the pressure of a rigorous academic load with aerobic activity can alleviate stress and anxiety which can be stored in the body. Even if your teen isn’t particularly athletic, help him or her to find ways to slow down, have more fun, and seek a more balanced lifestyle. Bowling, skating, or simply reading a good book are great ways to decompress. Engaging in fun and relaxing activities such as art, dance, and music can elicit positive emotions and social bonding.

The emotional, mental, and physiological symptoms of anxiety can be very frightening and confusing for teens. The good news? Anxiety is very common and quite treatable.

And, yes, it can also be overwhelming. If your student is struggling, have them speak with a ministry leader, school counselor, or a licensed therapist. A professional may be able to offer a different perspective you haven’t yet considered, or be able to give you tips and suggestions on how to encourage your teen during times of high stress or anxiety. At the very least, it’s one more person you’ll have in your student’s support circle.